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Video Details
Bone Augmentation and Implant Planning in a 3-D CBCT World

Description:
Don’t sit on the sidelines! Incorporate CBCT technology into your practice today for improved implant treatment planning, perio defect diagnostics, identification of perio-endo involvement, bone grafting evaluation, surgical guide fabrication and implant outcomes assessment. This presentation will highlight cases where CBCT unparalleled views positively affected diagnosis, treatment plans, outcomes and case acceptance.

Date Added:
7/8/2013

Author(s):

Bradley S. McAllister, DDS, PhD Bradley S. McAllister, DDS, PhD
Dr. McAllister received his DDS from the University of Washington and completed his periodontal specialty training and PhD in San Antonio at the University of Texas. H...
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Questions & Comments
Mario Marcone - (7/23/2013 8:10 PM)

Bradley, very much appreciate and thank you for putting this accuracy issue into proper perspective. Warmest Regards, Mario

Bradley McAllister - (7/23/2013 12:09 PM)

Sorry gang for the delay, i have been on holiday. Excellent questions bringing an important point that i should have elaborated on. Since no CT or CBCT unit is 100% accurate it is critical to not rely on the absolute distance numbers generated. The key location for accuracy is posterior mandible and i would still recommend a 2mm buffer to account for all of the potential sources of error. I have gotten closer than 2mm as i showed in the case where i took an intra-operative scan to confirm, however this does have risks associated so tread very cautiously as you go closer than 2mm. The articles cited by Mario bring up an excellent point that medical scanners do have the advantage of improved distance accuracy and they have better density accuracy for bone quality evaluation in the research environment. That said, i think there are very few instances where the error would be enough to warrant a medical scan for implant treatment planning. The deviation measurements in the Abboud article are a little misleading. I wish they would have used % rather than distance to present the deviations. The 2.17mm number was only once, with only the Sirona unit when making a 50mm measurement. All other CBCT units had less than 1mm deviation with a 50mm measurement (ie less than 2% deviation). When extrapolated to 10mm, the more relevant distance in the posterior mandible with a shorter implant that deviation would be less than 0.2mm. In practical terms what this means is that there is much more error generated in your measuring technique of identification of the true crest and the actual IAN than with the CBCT. I hope this helps. Cheers, Brad

Mario Marcone - (7/18/2013 7:44 AM)

Maurice, thank you. I am absolutely loving the Dental Xp experience. Thanks for the great work and the privilege for being able to share. Best Regards, Mario

Maurice Salama - (7/13/2013 11:59 AM)

Yes, Mario. We remain hopeful that Dr. McAllister will respond to the posting questions and comments in due time. Thanks for your comments. Dr. Salama

Mario Marcone - (7/11/2013 6:40 PM)

Dr McAllister, I would really be most appreciative if you could return some thoughts on my commentary. I think we would all learn from this, as we have learned listening to you ... Warmest Regards.

Mario Marcone - (7/10/2013 9:21 PM)

Thank you Bradley for this excellent presentation. Studies are emerging showing significant accuracy differences when comparing medical CT to CBCT. Here I present to you two studies in particular: - Accuracy of Bone Surface Size & Cortical Layer Thickness Measurements Using CBCT, Gerlach et al, COIR, 2013 - Comparison of Accuracy of CBCT & Medical-CT & Implications in Guided Surgery, Abboud et al, IJOMI, 2013 What comments can you offer about the situations where in certain cases attaining high accuracy is critical, and that a required surgical guide is generated using the CT planning for the purpose of optimizing accurate implant placement, but the CBCT-generated images are not accurate to begin with. Would you opt for the high accuracy of a medical CT at least to start the initial diagnostics and treatment palnning?

Maurice Salama - (7/10/2013 6:03 PM)

Nice job Bradley. Well done and put together. What is the accuracy of the 3D in most systems? 100%? Dr. Salama

Alan Hiura - (7/10/2013 5:25 PM)

very helpful, beautiful pictures

omid moghaddas - (7/10/2013 3:06 PM)

appreciate it Dr McAllister, enjoyed it.very comprehensive D Moghaddas

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